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C11Y OF TIGA RD
M1414 1:)EPMI:*T NO. : ME-(g82P9(.1
COMMUNITY DEVELOPMENT DEPARTMENT :I.1./
13125 C.'W,Hall Blvd..P.O.Box 2317,Tigard,Oregon 97223,1503)639-4 175 r,)A*Y*E. ISSIAM:
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rhis permit is issue('subject to the regu;ations contained in Title 14 ...........
of the TMC. slate of Oregon Specialty Codes,zoning regulations
and all other appli,Nble codes And ordinances, and it is hereby lNSPEUT10INS
agreed that the work will be done in Accordance with the plans and P(7ULAA 1.N
specifications and in compliance with all applicable codes aril
ordinances The issuRt.-e of this permit does riot waive iestriCuve
covenants. Contractor at,1 subcontractors shall have current city
bi.siness t- oermits This )ei mit will expire and become null Find
%-1,4if .ork is rot started w1oln 18ki days.or if work 1,.4 suspended or
abandoned for a period of .110 days any time After work ties
commenced It shall be the of the permittee to 11991.1re,
all required inspections are requested aru approved
i, r ittee4gnatwe
issued By kly I N F I" T 0 N 's'i 9 1. n)
SEPARATE PERMITS REOUIPT'D FOR WORK OTHER THAN DESCRIBED ABOVE
j BUILDING DEPARTMENT, TIGARD INTn s
PERMIT
holdr:r of a valid plutnbing contractors. Ilcens,' is hereby �
authorized to ca'.iSe plurnhi,,47viork as herein noted to be ;nst-lled in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who s!-lall be notified not less titan four �
(4) hours prier to t:-ie tim? the installations are ready for inspection. City of Tig,rd Business License required
for all contractors and Sub-conr,--c tors.
�Oar•mer._._.�_`ti'..��.__..._..____-_.___------------- Adc_ress-----.��`_._ �` _ Date.__ _.s�z..=dam
~- NUN1i•1FR OF —TOTAL PERMIT NO.'S }p
TYPE OF PERMIT ITe-h I rEE ON EAcli AMOUNT (Office Use Only)
H FsS 1P_F_LI T t•4 I._.____f
_S Ie F:.rttily-1 bath e+ch �- _ _ _— _-25.07 9lA
_Duplex-Each 1 bash unit —_ — I _ -25 00 -
4d�iticnel 10:00___._.____
tiobila Hgrn�S ra...;..ra:•h -_...-_-_.___ .._ _.___...__. ._..____.-.-._-.___...--- -.--__--_..__.�._....__`�..._-.—.—. ! '
1NUIVIDUAL FIX_l_URF FCES
1 to 50 Fixtur;!% in 1 buih - --•i -----
51 to 100 Fix ur;-; ;n 1 h. it t ich 2.50
• 101 to 2Ur1 Fi�r� . s �„ 1 t� � i l:- ; �:,7,:h 7 n)
i 2U or f:'1a r,. r i�.�t Sin 1 bu i I rl
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INSPECTION NOTICE
City of Tigard Building Department
'12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address — ------ '.�__ , :;• _.�. r_ Permit #----------
Type of Inspection
'Tire following Building Code deficiencies are requirad to be corrected:(-',-"'
( i P-esenvid to._ ...^
Date _ �Z . ^— _----- ----� _--
CALL FCW REiAi'S'DEMON
13 Yoe ❑ No
• 1
o'
BUILDING PERMIT APPLICATION TIGARD DATE��'�'� � ,9 3192
THE UNDERSIGNED HFREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE628 153'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER k'Ord 6u:irdin , , r; LOT NO. 'c'1er4kla E"�S♦
— JOB ADDRESS �<'7� °atd ��s,li,ri�, t. �.StAke4�3
erwCr. -
,'otext Winstl+:to 6tt• 3--19ax 160A-26-ftim � ,�
BUILDER ADDRESS G„SIQNER IrMiRbts vIld., Deni,-
STRUCTURE 12 NEWA ❑ REMODEL — ❑ ADDITION _-_❑_ REPAIR ❑ RENEWAL _❑ FIRE DAMAGE ❑ DEMOLITION
91 RESIDENCE L.) COMM CI EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 0 STORAGE ❑ SLAB FENCE
OCCUPANCY _ft�3 - N--7 + ^� d 3 „ DWH 6.1®rtric
_ LAND USE ZONE BLDG.TYPE .— FIRE ZONE_ _ LAN CHECK BY HEAT_ _
Canrstract si c le i"amily dWelliny w/attached gerayw. �3 Bedrooms - 2 Oaths. —
��, SEE CORRECTION SHEET ATTACHED,
SEWERPERMITN 21913 9705*00
OCC.LOAD FLOOR LOAD -40 — HEIGHT 14_ NO.STORIES 1 ! AREA_ll a9_NO.BEDROOMS 3 VALUAd b4,700.
BUILDING DEPARTMENT SET BACKS FRONT 11 REAR 18 LEFT SIDE_T RIGHT SIDE 6
Permlt 17 4'.00 _ THIS PERMIT IS ISSUED :SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS HEREBY AGREED THAT THE
Plan Check 86-011 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND 3PECIFsCATIONS AND IN COMPLIANCE
WITH ALLAPPLICAULE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES N(71 WAIVE
Sub-total _ .1513•CIU RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax GtiE3
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
A;, .
SDC— 0400.0(1
Total _ �;�b4.F�C�
By P1 PDCN I I 100 -Cl AO PPLICANTORAGENT
Receipt No. 58 1
Approved [)WFi -._.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor —
Permit No.
l - Rnugh•in
7/G.L _' � A4�.._�. AI�TCsal�lfri.awi�t hurl► 'i�(,�__.__ Fixture
1L�.112."" VAR "*T 6a.A A._�iN1 us—QAC WaT Li Final
tMab • /W_AWAY. Y HE:?TING 71
wk
Contractor
_ T p1�F. _ ---- --
.r �. Permit No.
Gas or 0
Hough
- _ ---- Final T
SEWER
DRIVEWAY
Final
Storm Drafnegr
__. _a— —�__• (Ruin Drain)Final, J-
Curb&Street Fines
Approach
MJXL CEPT.FINAL TEMPORARY CERTIFICATE OCCUP Final
CERTIrICATEOCCUPAP'iCY
(\,JI Landscaping
Toning Final
BUILDING PERMIT APPLICATION TIGAZ3 DATE
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR TME WORK HEREIN INDICATED BUILDER PHONi_C.°W�
OR AS SHOWN Ai ID APPROVED IN THE ACC WPANYING PLANS AND SPECIFICATIONS. OWNER PHO.F -?
OWNER f4-L+°''i.�. JOB ADDRESS S 2Q6�(-�'/�
'✓ 4 , TJ� ADDRESS �C�. .7 - 17011 �I��)Il-ZCO"S�f1o�AES M� ��t ��
a�
BUILDEr O _._ _-- I
° �r
STRUCTURE NFW 0 REM00EL ❑ ADDITION ,❑ REPAIR Cl RENEWAL ❑ FIRE DAMAGE �I'=i OEf,.OLITIC_r_!
RESIDENCE C COMM ❑ EDUCATICNAL ''❑ GOV'T ❑ RELIGIOUS Cl PATIO Cl CARPORT ❑ GARAGE ❑ STCRAGE ❑ S-LABIJ FES+Cv
OCCUPANCY _ LAND USE ZONE '_ _ BLDG.TYPE -FIRE ZONE PLAN CHECK BY 1-4 EAT -
- W/A ------- -
SEWER PERMIT p ---
OCC.LOAD _FLUOR LOAD/� HEIGHT_& N0.STORIES_ AREA��- N0.BECIROJMS ..7 V6,LU:�J�?Op
BUILDING DEPARTMENT .213y--� SFT BACKS FRONT ,2O REAR dLEFT SiCE �3 FIGHT SIDE �p
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COLE,ZON'N
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 17 IS HEREBY AGRCEO T'i'aT THF
Plan Check VV r WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANC:
f WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PZ.R`AIT DOES NOT WAIVE
Sub-totalI �� RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS T'O HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING ANC HEATING.
Cht9 Tax •
SDC—
Total _
ppm APPLICANT Oa AGENT
sy
.� Rerelpt No.
Approved ADDRESS PHONE
SDC -
QDC
SEWER CONNECTION
SEWER INSPECTION � �•! _
SEWER SURCHARGE S —
r/20�
Comments :
op
\V�►riat�/ tub IS uN'D AMY .z7) 19 vo
30 3&(
22 -( qn
1 z-cox 241 G 3 i
37, 088
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3q� �9 t8 710 _..
�i'0:� �oul`i4v�st C3�;rt;l�;aln
0, ORF WN 972e` _
ATTENTION
.y
GENTLEMEN:
--- WE ARE SENDING YOU U Attached H Under separate rover the following items:
❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of Istter ❑ Change order ❑—_�_-----.--,-- --- -- —
COPIES DATE NO. DESCRIPTION
THESE ARE TRANSMITTED as checked below:
LJ For approval ❑ Approved as submitted ❑ Resubmit__..-__copies for approval
❑ For your use ❑ Approved as noted ❑ Submit--copies for distribution
-- ❑ As requested ❑ Returned for corrections ❑ Return,----corrected prints
rl For review and comment ❑ - -
f] FOR BIDS DUE _19 __-—. ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
COPY TO-----
SIGNED:
If enclosures are not as noted, kindly notify us of once.
rnAm a4n a A.MblAf'MrI�"179� erolen.Mn411100
k,i I Y ur- i IU>N►HU MECHANICAL PERMIT Permit Permit # z-7-.��
N
Description
Table 3A Mechanical Cou_e__ OTY PRICE AMT
City ofr igard 1) Permit Fee -0- -0- 10.00
13125.>.V01, Hall Blvd.
P.O. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223
639-4175 1) Furnace to 100,000 BTU 600
incl,ducts&vents
Furnace 100,000 BTU +
2 incl.ducts&vents 7.50
Name of Development3) Floor Furnace
I� 6.00
Job Address I tr�� �T✓�� Suspended heater,wall heater
Address 4) or floor mounted heater 6.00
Tax Lot Map No. ) Vent not incl.in 3.00Lot Back subdivision 5 appliance permit
Name(or name of business) Repair of heating,refr ig.,
6) cooling,absorption unit 6.00
MallingAddresa Phut 7) Boiler or comp to 3 HP 800
Owner -� 6ac)-94 absorp.unit to 100,000 BTU
City/stats o zips 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Na 9) Boiler or comp 15.30 HP 1500
absorp.unit Yz-1 million
Mailing Addreas phone 10) Boiler or camn to 30-50 HP 22.50
_ :,bsorp.unit 1-1.75 million
Contractor city/State Zip 11) Boiler or comp to 50 HP 31-50
absorp.unit 1,750,000 BTU
s+eta negiaration No City Bus Tax No 12) Air handling unit to 4.50
10,000 CFM
I hereby acknowledge That I have read this application that the information handling unitn given le 13) 10,000 CFM + 7'50
coned,that I am the owner or authorized agent of the owner,that plans submitted are In
compliance with State laws,that 1 am registered with the Stale Builders'Board,that the 14 Non portable
number given Is correct.Mexempt from State registration please give reason below) ) evaporate cooler 4.50
Vent fan connected
15 to a single duct 3.00
- - - - — --- Ventilation system not
i 6) included in appliance permit 4.50
17) Hood served by 4.50
mechanical exhaust
Signature(owner or agent) - Date 18) Domestic type 7.50
Describe workdditl n F1 a'teratlrepair [_) _ incinerator
to be done - resi enlial non-residential 0 - t 9) Commercial or industrial 30.00
Existing use of type incinerator
building or properly--- 20) Other i.e.,woodslove,water
4.50
l tes dryers,etc.
et
Proposed use of heater,solar,clot _
building or property _ _--__,_._. 21) Gas piping one to four outlets 2.00
Type of fuel- oil C] natural gas I 1 LPG [1) electric ! 'i -
222 Moie than 4-per outlet
NQTLQE
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WOFIK OR CON --
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 S010 406 SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
A13ANDONED FOR A PERIOD OF 180 DAYS AT ANY TIMF AFTER ---- -- -- --- - - -
WORK IS COMMENCED TOTAL
:ilmclal Conditions
Driletssued by